Medical Mystery Monday #93: the case of the swollen face

Hope everyone enjoyed the gorgeous weekend! Can you guess what our patient has?

A worried mother brings her one year old to the pediatrician because of a swollen left face. She states for the past two days, her child has felt warm and has been lethargic, unwilling to get out of bed to play. The baby’s face then swelled up, he began tugging on his ear, and he became irritable, and he refused to eat, so she decided to bring him to the doctor. The mother does not believe in vaccinations, so the patient has not received any.

On physical exam, the patient is noted to be screaming and uncomfortable appearing. He has a fever of 101. The left side of his face is swollen around the ear, cheek, and under the chin (shown below). The doctor examines within the patient’s mouth, which is shown below.

What is the most likely diagnosis?

The child's face.

The inside of the patient's mouth. From American Academy of Pediatrics.